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Individual
TIEQUENCCIA MITCHELL
Active
Individual
TIEQUENCCIA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
IHCP-0345
SC
253Z00000X
In Home Supportive Care Agency
Primary
IHCP-0345
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX1476
—
SC
01
—
IHCP-0345
DHEC
SC
Enumeration date
04/20/2016
Last updated
10/22/2019
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